Provider Demographics
NPI:1073922092
Name:CHIE, MEI SHAN ANITA (OTR)
Entity Type:Individual
Prefix:
First Name:MEI SHAN ANITA
Middle Name:
Last Name:CHIE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 S 5TH ST APT G
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3708
Mailing Address - Country:US
Mailing Address - Phone:469-569-2998
Mailing Address - Fax:
Practice Address - Street 1:58 S 5TH ST APT G
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3708
Practice Address - Country:US
Practice Address - Phone:469-569-2998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114032225X00000X
CA12806225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist